Nosocomial Infections in Very Low Birth Weight Infants: Etiology and Risk Factors

Year 2017, Volume: 07 Issue: 01, 7 - 12, 01.03.2017

V. Vamsi Sivarama Raju

https://doi.org/10.5799/jmid.328836

Abstract

Objective: We aimed to find out the incidence and risk factors of nosocomial infections in VLBW neonates and to
explore the microbiologic flora, sensitivity pattern and outcome.
Methods: A prospective, observational study was performed in a neonatal intensive care unit of a teaching hospital.
VLBW infants excluding those diagnosed with early onset sepsis, admitted to the unit between August 2012 and
March 2013 were followed up for evidence of nosocomial sepsis.
Results: Of 92 VLBW infants, 23 developed nosocomial sepsis, incidence rate being 25%. Decreasing birth weight
(1251-1500 g, 10.9%; 1001-1250 g, 28%; 751-1000 g, 50%; P<.001) and gestational age (>33wks, 0%; 29-32wks,
21.3%; 26-28 wks, 66.7%; p<.001) were found to be associated with statistically significant increase in nosocomial
sepsis rate.
On multivariate logistic regression, only peripherally inserted central catheter (PICC) line was independently
associated with increased risk of nosocomial sepsis (aOR 13.33, 95% CI 3.58-49.5) in VLBW.
A predominance of Gram negative over Gram positive nosocomial sepsis (75% vs. 25%) with higher mortality in the
Gram negative group (55% vs. 0%) was observed. Klebsiella pneumoniae was the predominant microbe (33.4%). All
microbes were sensitive to first line antibiotics except Elizabeth kingia meningoseptica and one episode of K.
pneumoniae. Seven (30.4%) VLBW neonates with nosocomial sepsis died.
Conclusions: Among VLBW infants, the incidence of nosocomial sepsis was 25%. Lower birth weight, lesser
gestational age and PICC line were important risk factors. Gram negative nosocomial sepsis was associated with
higher mortality compared to Gram positive sepsis. J Microbiol Infect Dis 2017; 7(1): 7-12      

Keywords

Neonates, Nosocomial sepsis, VLBW infants

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